Expert: Dr Alan Galbraith - 12/30/2003

Question
I recently read an article that stated that Coversyl(perindopril erbumine) can have a side effect: irregular heartbeats, albeit at low frequency. The reason given was Potassium retention. At the same time caution was advised when using a diuretic in conjunction with Coversyl because the side effect could be intensified. Surely the diuretic would deplete the potasium and therefore counterbalance the downside of the Coversyl.Have there been any reports of angio tensin drugs contributing to errectile difficulties.?  

Answer
Dear Russell

A very good question. You are correct in that most diuretics such as the loop (frusemide) and the thiazides will counteract the potassium retention caused by perindopril and because of this perindopril is actually available combined with indapamide (a thiazide like diuretic) as Coversyl Plus. However, there are some diuretics such as amiloride and spironolactone which cause potassium retention which may be the ones referred to in your article. Furthermore you can get paradoxical reactions in some people where perindopril does induce potassium loss.

ACE inhibitors have been implicated in erectile dysfunction but this is uncommon and have not been much different from a placebo.

Regards

Dr Alan Galbraith